IVMS-Autonomic Pharmacology Formative Exam with Answer Key

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IVMS-Autonomic Pharmacology Formative Exam with Answer Key

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IVMS-Autonomic Pharmacology Formative Exam with Answer Key

  1. 1. Marc Imhotep Cray, M.D. Autonomics Formative ExamInstructions: Select the One Best Answer1. Symptoms that might be helpful in distinguishing between cholinergiccrisis(e.g., overdose with cholinesterase inhibitors) and an acuteexacerbation of myasthenia gravis include: A. increased salivation B. muscle fasciculations (twitching) C. profuse sweating D. muscle weakness1. A,B,C2. A,C3. B,D4. D only5. All of the above2. Drug Y produces a slowing heart rate when injected intravenously into ananimal. This slowing in heart rate does not occur if the animal isbilaterally vagotomized. Drug Y may be: A. phenylephrine B. levarterenol C. methoxamine D. isoproterenol1. A,B,C2. A,C3. B,D4. D only5. All of the above3. The rate-limiting step in the biosynthesis of norepinephrine involves theenzyme:1. tryptophan hydroxylase2. phenylalanine hydroxylase3. dopamine beta-hydroxylase4. tyrosine hydroxylase5. tryptophan decarboxylase Autonomics Formative ExamPage 1
  2. 2. Marc Imhotep Cray, M.D.4. Neurotransmitters found within the central nervous system include: A. dopamine B. gamma-aminobutyric acid (GABA) C. 5-hydroxytryptamine (Serotonin) D. norepinephrine1. A,B,C2. A,C3. B,D4. D only5. All of the above5. Your pharmacology laboratory has been given a new compound for screening.It is found to increase the heart rate but has no effect on the eye. It alsocaused a significant reduction in diastolic blood pressure as well asrelaxation of the bronchial muscle. This compound would be categorized as:1. antimuscarinic2. beta agonist3. beta antagonist4. alpha antagonist5. muscarinic6. All of the following statements concerning the structure-activityrelationships of sympathomimetic amines are true EXCEPT:1. the presence of a hydroxyl group in the 3 and 4 positions on the benzene ring is characteristic of the "catechol" nucleus2. resistance to monamine oxidase is conferred by alkyl substitution on the alpha carbon of the phenylethylamine structure3. the presence of hydroxyl groups in the 3 and 5 positions of a benzene ring increases the specificity for beta-1 receptors in the lung4. a large alkyl substitution on the amino group of a direct-acting sympathomimetic increases the specificity for beta receptors5. the absence of hydroxyl groups of the benzene ring of indirect-acting sympathomimetic amines increases oral effectiveness7. Recent investigation has demonstrated the existence of both presynapticalpha receptors (à2) and postsynaptic alpha receptors (à1). All of the followingstatements concerning these alpha receptors are true EXCEPT:1. clonidine is an à2 selective agonist2. methoxamine and phenylephrine are à2 selective agonists3. prazosin and phenoxybenzamine are à1 selective antagonists4. phentolamine is a nonselective alpha antagonist5. epinephrine and norepinephrine are nonselective alpha agonists Autonomics Formative ExamPage 2
  3. 3. Marc Imhotep Cray, M.D.8. All of the following statements concerning physostigmine and neostigmine aretrue EXCEPT:1. physostigmine and neostigmine are classified as reversible cholinesterase inhibitors2. neostigmine stimulates nicotinic receptors at ganglia and neuromuscular junctions unlike physostigmine3. physostigmine is well absorbed orally4. a major problem encountered with neostigmine is the unpleasant central nervous system effects which result from its administration5. physostigmine is a tertiary amine and is able to penetrate the central nervous system9. All of the following statements are true concerning effects of intravenousinfusion of norepinephrine at 10 UG/Min EXCEPT:1. an increase in pulse rate2. an increase in pulse pressure3. a marked increase in peripheral resistance4. an increase in systolic blood pressure5. an increase in diastolic blood pressure10. Your pharmacology laboratory has been given an unknown compound forscreening.It is found to contract the sphincter muscle of the eye, decrease the heartrate, increase bronchial gland secretions and causes sweating. You wouldclassify this compound as (an):1. antimuscarinic2. alpha agonist3. alpha antagonist4. beta antagonist5. muscarinic11. True statements concerning the parasympathetic and sympathetic branchesof theautonomic nervous system include:1. parasympathetic branch predominates under normal physiologic conditions while the sympathetic branch predominates during stressful episodes2. acetylcholine is the chemical mediator at the ganglia of both branches and causes stimulation of nicotinic receptors postsynaptically3. the adrenal medulla acts as a postganglionic sympathetic neuron and produces norepinephrine which travels via the bloodstream to stimulate alpha, beta-1 and beta-1 receptors4. 1,25. 1,3 Autonomics Formative ExamPage 3
  4. 4. Marc Imhotep Cray, M.D.12. Which of the following statements is (are) correct concerning adrenergicdrugs? A. at beta-1 receptors, isoproterenol is more potent than epinephrine, which is equipotent with norepinephrine B. at alpha-1 receptors, epinephrine is less potent than norepinephrine, which in turn is much more potent than isoproterenol C. at alpha-1 receptors, epinephrine is equal to or more potent than norepinephrine, which in turn is much more potent than isoproterenol D. at beta-2 receptors, isoproterenol is equal to or more potent than epinephrine, which is much less potent than norepinephrine1. A,B,C2. A,C3. B,D4. D only5. All of the above13. All of the following statements concerning catecholamine biosynthesisare true EXCEPT:1. all of the enzymes involved with catecholamine biosynthesis are highly specific for each substance2. tyrosine hydroxylase is the rate-limiting enzyme in catecholamine biosynthesis3. the level of glucocorticoid influences the concentration of phenyl-n-methyltransferase and hence the conversion of norepinephrine to epinephrine4. the conversion of tyrosine to dopa and dopa to dopamine occurs in the cytoplasm of the adrenergic nerve terminal5. the conversion of dopamine to norepinephrine via dopamine beta-hydroxylase tales place within the granule of the adrenergic nerve terminal Autonomics Formative ExamPage 4
  5. 5. Marc Imhotep Cray, M.D.14. Which of the following statements concerning the nerve action potential is(are) correct? A. an inhibitory neurotransmitter causes a selective decrease in permeability to potassium and chloride resulting in hyperpolarization (IPSP) B. an excitatory neurotransmitter causes a selective increase in permeability to all types of ions resulting in an excitatory postsynaptic potential (EPSP) C. conduction of the action potential refers to passage of an impulse along an axon or muscle fiber D. an inhibitory neurotransmitter causes a selective increase in permeability to potassium and chloride resulting in hyperpolarization (IPSP)1. A,B,C2. A,C3. B,D4. B,C,D5. D only15. Your pharmacology laboratory has received a new compound for screening.Initial experimentation with the compound yields the following findings: Itcauses contraction of the detrusor muscle of the urinary bladder, contractionof the sphincter muscle of the iris, and secretion of lacrimal glands. Withthis information you might initially classify the compound as a(an):1. alpha agonist2. muscarinic agonist3. beta agonist4. anticholinergic5. alpha antagonist16. Respiratory effects of epinephrine include all of the following EXCEPT:1. relaxation of bronchial smooth muscle2. inhibition of antigen-induced release of histamine3. potent central nervous system stimulation4. increase in respiratory rate and tidal volume5. constriction of pulmonary vessels when administered as an aerosol Autonomics Formative ExamPage 5
  6. 6. Marc Imhotep Cray, M.D.17. Correct statements concerning receptor location include: A. nicotine (N1) receptors have been found to occur at autonomic ganglion cells B. alpha adrenergic receptors have been found to exist on presynaptic terminals (à1) in addition to other locations such as blood platelets C. beta adrenergic receptors have been found in the heart ( 1) and in other sites ( 2) D. muscarinic receptors have been localized to the autonomic effector cells of the sympathetic nervous system1. A,B,C2. A,C3. B,D4. D only5. All of the above18. All of the following drugs are examples of direct acting beta agonistsEXCEPT:1. phenylephrine2. metaproterenol3. isoetharine4. albuterol5. terbutaline19. Which of the following statements concerning the intravenous administrationof catecholamines is (are) true? A. isoproterenol causes a decrease in peripheral resistance and A significant increase in pulse rate B. norepinephrine causes an increase in pulse rate and peripheral resistance C. epinephrine causes an increase in pulse rate and a decrease in peripheral resistance D. norepinephrine causes an increase in systolic blood pressure and a decrease in diastolic pressure1. A,B,C2. A,C3. B,D4. D only5. All of the above Autonomics Formative ExamPage 6
  7. 7. Marc Imhotep Cray, M.D.20. Preterm labor can be terminated by the use of drugs which cause relaxationof uterine smooth muscle. Drugs which have been used for this purpose include: A. fenoterol B. ritodrine C. terbutaline D. metoprolol1. A,B,C2. A,C3. B,D4. D only5. All of the above21. Which of the following statements are true concerning the autonomicnervous system? A. the principle neurotransmitter of the sans is norepinephrine B. the PANS is characterized by long preganglionic and short postganglionic fibers C. the principle neurotransmitter of the pans is acetylcholine D. acetylcholine is the neurotransmitter that stimulates the adrenal gland to release catecholamine1. A,B,C2. A,C3. B,D4. D only5. All of the above22. Your pharmacology laboratory has a new compound for screening. It isfound to cause tachycardia, mydriasis, urinary retention and cycloplegia. Youwould classify this agent as a(an):1. alpha agonist2. ganglionic blocker3. beta-1 agonist4. nicotinic agonist5. muscarinic agonist23. The most important mechanism for terminating the activity of releasednorepinephrine from the presynaptic terminal is:1. uptake-22. enzymatic destruction3. diffusion into the systemic circulation4. uptake-15. presynaptic receptor stimulation Autonomics Formative ExamPage 7
  8. 8. Marc Imhotep Cray, M.D.24. A pharmacology laboratory is given a new compound for screening. Thisdrug causes mydriasis and bradycardia, and causes pain and difficulty inmicturition. You would classify this compound as a(an):1. alpha agonist2. anticholinergic3. muscarinic agonist4. beta blocker5. nicotinic antagonist25. All of the following drugs are examples of direct acting alpha agonistsEXCEPT: A. phenylephrine B. metaraminol C. methoxamine D. metaproterenol1. A,B,C2. A,C3. B,D4. D only5. All of the above26. A patient with a history of thioridazine ingestion enters the emergency roomexhibiting the following signs: delirium, mydriasis, tachycardia and dry skin.A drug which could help you confirm the patients ingestion is:1. phenylephrine2. naloxone3. physostigmine4. edrophonium5. neostigmine27. Your pharmacology laboratory has received a new alpha agonist forscreening. Which of the following effects would you expect to see if you initiallyadminister atropine followed by the alpha agonist? A. mydriasis B. bradycardia C. urinary retention D. salivation1. A,B,C2. A,C3. B,D4. D only5. All of the above Autonomics Formative ExamPage 8
  9. 9. Marc Imhotep Cray, M.D.28. Which of the following statements concerning the mechanisms of action ofautonomic drugs is (are) true? A. atropine effectively antagonizes the action of acetylcholine at muscarinic and nicotinic sites B. quaternary anticholinesterase inhibitors exert both indirect and direct effects at nicotinic sites C. ganglionic blocking agents are not widely used today principally because of the multiple CNS toxicities D. alpha agonists are thought to stimulate the recently discovered alpha receptors which have been subdivided into two populations: alpha-1 (postsynaptic) and alpha-2 (presynaptic)1. A,B,C2. A,C3. B,D4. D only5. All of the above29. Which of the following statements accurately describe the concept"transmitter economy"? A. transmitter economy refers to the reuptake of released catecholamine for subsequent reutilization in neurotransmission B. transmitter economy refers to the reuptake of choline in the synaptic cleft for reutilization in acetylcholine synthesis C. transmitter economy refers to a process which helps to conserve synaptic supplies of norepinephrine D. transmitter economy is a process coined by Alexander Regan which ascribes receptor down regulation to supply side economics1. A,B,C2. A,C3. B,D4. D only5. All of the above30. Which of the following statements are true? A. terbutaline is relatively specific for Beta-2 receptors and is used as a bronchodilator B. guanethidine blocks responses to indirect acting sympathomimetic amines and potentiates they actions of exogenous epinephrine by inhibiting neuronal uptake C. MAO (monoamine oxidase) is the enzyme which catalyzes the oxidative deamination of catecholamines to form aldehyde derivatives D. yohimbine is an ergot alkaloid which has beta blocking activity1. A,B,C2. A,C3. B,D4. D only5. All of the above Autonomics Formative ExamPage 9
  10. 10. Marc Imhotep Cray, M.D.31. Correct statements concerning physostigmine and neostigmine include: A. physostigmine and neostigmine are both classified as reversible cholinesterase inhibitors B. physostigmine, unlike neostigmine, is thought to exert a direct stimulatory effect at nicotinic receptors C. physostigmine is classified as a tertiary amine whereas neostigmine is a quaternary salt D. neostigmine should be used in place of physostigmine for reversal of central anticholinergic toxicity1. A,B,C2. A,C3. B,D4. D only5. All of the above32. Which of the following statements is (are) true? A. the veins are predominantly under sympathetic control B. the heart is predominantly under sympathetic control C. the urinary bladder is predominantly under parasympathetic control D. the arterioles are predominantly under parasympathetic control1. A,B,C2. A,C3. B,D4. D only5. All are correct33. Correct statements regarding the D-2 receptor include: A. the ergot alkaloids act as agonists at the receptor B. the D-2 Receptor is generally less sensitive to dopamine agonists than is the D-1 receptor C. metoclopramide is felt to be a selective antagonist at the D-2 receptor D. the prototype location for the D-2 receptor is the parathyroid gland1. A,B,C2. A,C3. B,D4. D only5. All of the above34. All of the following classes of drugs can demonstrate anticholinergic sideeffects EXCEPT:1. tricyclic antidepressants2. antihistamines3. phenothiazines4. anticonvulsants5. All of the above Autonomics Formative ExamPage 10
  11. 11. Marc Imhotep Cray, M.D.35. Which of the following statements concerning anticholinesterases is (are)true? A. pyridostigmine is a quaternary compound which is administered orally for the treatment of myasthenia gravis B. they act as "decurarizing drugs and will reverse the antagonism of competitive neuromuscular blocking agents C. physostigmine is a tertiary compound which is regarded as the anticholinesterase of choice for reversal of CNS anticholinergic toxicity D. unlike the tertiary anticholinesterases, quaternary compounds have direct agonist effects at the neuromuscular junction1. A,B,C2. A,C3. B,D4. D only5. All of the above36. Potential sites for cholinergic synapses include: A. autonomic effector sites, innervated by postganglionic parasympathetic fibers B. sympathetic and parasympathetic ganglion cells, and the adrenal medulla C. motor end-plates on skeletal muscles D. certain synapses within the central nervous system1. A,B,C2. A,C3. B,D4. D only5. All of the above37. Your pharmacology laboratory has received a compound for testingpurposes. Initial experimentation with the compound yields the followingobservations: It causes contraction of the radial muscle of the iris, constriction ofthe arterioles of the skin and mucosa, and hyperglycemia. You would classify thiscompound as a(an):1. anticholinergic2. beta blocker3. alpha agonist4. muscarinic5. antimuscarinic38. The rate-limiting enzyme in catecholamine biosynthesis is:1. aromatic l-amino acid decarboxylase2. dopamine-beta-hydroxylase3. tryptophan hydroxylase4. phenylalanine hydroxylase5. None of the above Autonomics Formative ExamPage 11
  12. 12. Marc Imhotep Cray, M.D.39. Drugs which have no nicotinic activity, and are resistant to the activity ofacetylcholinesterase include: A. acetylcholine B. methacholine C. carbachol D. bethanechol1. A,B,C2. A,C3. B,D4. D only5. All of the above40. Examples of pharmacologic effects of ganglionic blocking drugs include: A. cycloplegia B. vasodilatation, increased peripheral blood flow; hypotension C. anhidrosis D. bradycardia1. A,B,C2. A,C3. B,D4. D only5. All of the above41. Correct statements regarding the anticholinergic drugs, atropine andscopolamine, include: A. scopolamine has a more potent action on the iris, ciliary body, and certain secretory glands (salivary, bronchial, and sweat) B. scopolamine does not depress the central nervous system in doses that are used clinically and therefore is given in preference to atropine for most purposes C. atropine is more potent than scopolamine on the heart, intestine and bronchial muscle D. scopolamine has a longer duration of action that atropine1. A,B,C2. A,C3. B,D4. D only5. None of the above Autonomics Formative ExamPage 12
  13. 13. Marc Imhotep Cray, M.D.42. Which of the following metabolic effects are observed following epinephrineadministration? A. decrease in uptake of glucose by peripheral tissues B. increase in free fatty acids via activation of triglyceride lipase C. transient increase in serum potassium due to release of the ion from the liver D. inhibition of insulin secretion via stimulation of beta receptors1. A,B,C2. A,C3. B only4. B,D5. All of the above43. Correct statements regarding the pharmacological actions of anticholinergicsinclude: A. gastric secretion is greatly altered by conventional doses of belladonna alkaloids B. full therapeutic doses of atropine sulfate produce definite and prolonged inhibitory effects on the motor activity of the stomach, duodenum, jejunum, ileum, and colon C. anticholinergic doses needed to produce inhibition of gastrointestinal motor activity are sufficient to depress salivary secretion and usually produce ocular and cardiac effects D. atropine reduces the secretion of pancreatic juice and bile1. A,B,C2. A,C3. A,D4. B and C5. All of the above44. All of the following statements regarding cholinergic blockage are trueEXCEPT:1. muscarinic actions of all parasympathomimetic drugs are blocked selectively by atropine, through competitive occupation of cholinergic receptors2. epinephrine and other sympathomimetic amines antagonize most muscarinic effects at sites where adrenergic and cholinergic impulses produce opposing effects3. nicotinic effects of acetylcholine and its derivatives at autonomic ganglia are blocked by hexamethonium4. nicotinic effects of acetylcholine and its derivatives at the neuromuscular junction of skeletal muscle are antagonized by D- tubocurarine5. muscarinic effects of acetylcholine and its derivatives at autonomic ganglia are blocked by hexamethonium Autonomics Formative ExamPage 13
  14. 14. Marc Imhotep Cray, M.D.45. Which of the following regulatory agents or conditions would be expected tocause a decrease in the number of beta-adrenergic receptors? A. propranolol B. guanethidine C. alcohol withdrawal D. beta-adrenergic agonists1. A,B,C2. A,C3. B,D4. D only5. All of the above46. Which of the following statements regarding the central noradrenergicneuron is (are) true? A. alpha-methyl tyrosine can block the tyrosine hydroxylase reaction in catecholamine biosynthesis via competitive inhibition B. tetrabenazine and reserpine both interfere with the uptake storage mechanism of the noradrenergic neuron; however the tetrabenazine effects do not appear to be irreversible C. norepinephrine has its action terminated principally by reuptake into the presynaptic neuron D. norepinephrine and dopamine present in a free state with the presynaptic terminal can be degraded by COMT, which appears to be located in the outer membrane of the mitochondria1. A,B,C2. A,C3. B,D4. D only5. All of the above47. All of the following drugs are classified as indirect or mixed acting agentsEXCEPT: A. ephedrine B. dopamine C. amphetamine D. dobutamine1. A,B,C2. A,C3. B,D4. D only5. None of the above; all are correct Autonomics Formative ExamPage 14
  15. 15. Marc Imhotep Cray, M.D.48. Ganglionic blockade would be expected to give rise to all of the followingEXCEPT:1. arteriolar vasodilation, increased peripheral flow and hypotension2. venodilation, pooling of blood, decreased venous return, and decreased cardiac output3. reduced gastrointestinal tone and motility; constipation4. bradycardia5. All of the above49. All of the following statements concerning the effects of anticholinesteraseagents are true EXCEPT:1. when applied topically to the anti-cholinesterase agents cause conjunctival hyperemia, miosis, and constriction of the ciliary muscle2. enhancement of gastric contractions and increased secretion of gastric acid from parietal cells3. augmentation of secretory function in bronchial, lacrimal, sweat, salivary, gastric, and intestinal glands4. increase the effective refractory period of cardiac muscle and decrease the conduction time in conducting tissue5. stimulation followed by depression or paralysis, of all autonomic ganglia and skeletal muscle (nicotinic action)50. The passage of impulses at autonomic ganglia can be influenced by drugsthat act to:1. interfere with the storage of synthesis of the transmitter (e.g., hemicholinium)2. prevent the liberation of acetylcholine from the preganglionic nerve endings (e.g., botulinus toxin)3. inactivate ganglionic cholinesterases (e.g., physostigmine)4. either mimic or prevent the interaction between acetylcholine and its ganglionic (nicotinic) cholinergic receptor sites5. All of the above51. Neurotransmitters found within the central nervous system include all of thefollowing EXCEPT:1. 5-hydroxytryptamine2. glutamate3. GABA4. dopamine5. isoproterenol Autonomics Formative ExamPage 15
  16. 16. Marc Imhotep Cray, M.D.52. Manifestations of ganglionic blockade include: A. mydriasis B. urinary retention C. tachycardia D. decreased venous return1. A,B,C2. A,C3. B,D4. D only5. All of the above53. All of the following drugs act on beta-adrenergic receptors EXCEPT: A. metaproterenol B. isoetharine C. terbutaline D. bethanechol1. A,B,C2. A,C3. B,D4. D only5. All of the above54. Which of the following drugs has no nicotinic activity? A. methacholine B. pilocarpine C. carbachol D. bethanechol1. A,B,C2. A,C3. B,D4. D only5. None of the above55. The drug which would be most effective in reversing the centralmanifestations of anticholinergic toxicity is:1. edrophonium2. pyridostigmine3. neostigmine4. physostigmine5. scopolamine Autonomics Formative ExamPage 16
  17. 17. Marc Imhotep Cray, M.D.56. Direct acting cholinergic agonists include: A. physostigmine B. muscarine C. propantheline D. pilocarpine1. A,B,C2. A,C3. B,D4. D only5. All of the above57. Which of the following drugs is an antagonist at nicotinic (N1)receptors?1. atropine2. curare3. scopolamine4. hexamethonium5. neostigmine58. Which of the following drug classes do not demonstrate anticholinergiceffects? A. phenothiazines B. antiarrhythmics C. antihistamines D. tricyclic antidepressants1. A,B,C2. A,C3. B,D4. D only5. None of the above59. Which of the following drugs is classified as a selective alpha-1 agonist?1. prazosin2. norepinephrine3. phenylephrine4. phenoxybenzamine5. epinephrine60. The activity of norepinephrine released at the synaptic cleft is terminatedprincipally by which of the following processes?1. uptake-12. uptake-23. removal by the bloodstream4. stimulation of presynaptic autoreceptors5. enzymatic destruction within the synaptic cleft Autonomics Formative ExamPage 17
  18. 18. Marc Imhotep Cray, M.D.61. Your pharmacology laboratory is given a new compound for screening. It isfound to increase heart rate, reduce blood pressure and reduce uterinecontractility. You would classify this agent as:1. beta agonist2. muscarinic agonist3. nicotinic agonist4. alpha antagonist5. antimuscarinic62. Drugs which exert their effects (either agonist or antagonist) on presynapticalpha receptors (alpha-2) include: A. phenylephrine B. clonidine C. prazosin D. yohimbine1. A,B,C2. A,B3. A,C4. B,D5. C,D63. Nicotinic receptors are situated at which of the following locations? A. adrenal gland B. neuromuscular junction C. central nervous system D. autonomic ganglia1. A,B,C2. A,B3. A,C4. B,D5. All of the above64. Drugs contraindicated in the management of patients with asthma include allofthe following EXCEPT:1. physostigmine2. bethanechol3. propranolol4. atropine5. methacholine Autonomics Formative ExamPage 18
  19. 19. Marc Imhotep Cray, M.D.65. All of the following statements concerning the cholinergic and adrenergicreceptors are true EXCEPT: A. nicotinic (N2) receptors are found at the neuromuscular junction B. nicotinic (N1) receptors are found at the autonomic ganglia C. beta-1 receptors are found chiefly at cardiac sites and beta-2 receptors are found in smooth muscle and gland cells D. alpha-1 receptors are localized to presynaptic terminals whereas alpha-2 receptors are found at postsynaptic sites1. A,B,C2. A,C3. B,D4. D only5. All of the above66. Pharmacologic effects of ganglionic blocking drugs include: A. cycloplegia B. sweating C. vasodilation, hypotension, increased peripheral blood flow D. bradycardia1. A,B,C2. A,C3. B,D4. D only5. All of the above67. Acetylcholine is the neurotransmitter at which of the following cholinergicreceptor sites?1. nicotinic2. neuromuscular3. nonnicotinic ganglionic4. All of the above5. 1,268. Prevertebral ganglia include:1. superior cervical2. superior mesenteric3. celiac4. 1,25. 2,3 Autonomics Formative ExamPage 19
  20. 20. Marc Imhotep Cray, M.D.69. Monamine oxidase and catechol-o-methyltransferase are the true importantenzymes in the initial steps of catecholamine metabolism. The principalresulting metabolites include: A. 5-HIAA (5-hydroxyindoleacetic acid) B. VMA (vanillylmandelic acid) C. SKP (SKP-2-NXT-SER) D. MHPG (3-methoxy-4-hydroxy phenylglycol)1. A,B,C2. A,C3. B,D4. D only5. All of the above70. Examples of indirect-acting sympathomimetics include: A. amphetamine B. methoxamine C. hydroxyamphetamine D. phenylephrine1. A,B,C2. A,C3. B,D4. D only5. All of the above71. An unknown compound causes miosis, drowsiness and mental clouding,respiratorydepression, nausea and constipation. You would classify this compound as:1. antimuscarinic2. muscarinic3. alpha agonist4. alpha antagonist5. None of the above72. Your basement pharmacology laboratory correctly identified an unknowncompound several years ago. This compound caused an increase in heart rate,reduction in mean blood pressure and relaxation of bronchial smooth muscle.This compound is marketed today under the names of:1. propranolol2. isoproterenol3. trimethaphan4. phenylephrine5. bethanechol Autonomics Formative ExamPage 20
  21. 21. Marc Imhotep Cray, M.D.73. Your pharmacology laboratory has been given a new compound forscreening. It is found to increase heart rate, dilate the pupil, reduce glandularsecretions and decrease gastrointestinal motility. You would classify thiscompound asa(an):1. alpha agonist2. antimuscarinic3. beta agonist4. parasympathomimetic5. beta agonist Autonomics Formative ExamPage 21
  22. 22. Marc Imhotep Cray, M.D.ANWER KEY: 1. correct answer: 5 category: Autonomics 2. correct answer: 1 category: Autonomics 3. correct answer: 4 category: Autonomics 4. correct answer: 5 category: Autonomics 5. correct answer: 2 category: Autonomics 6. correct answer: 3 category: Autonomics 7. correct answer: 2 category: Autonomics 8. correct answer: 4 category: Autonomics 9. correct answer: 1 category: Autonomics 10. correct answer: 5 category: Autonomics 11. correct answer: 4 category: Autonomics 12. correct answer: 2 category: Autonomics 13. correct answer: 1 category: Autonomics 14. correct answer: 4 category: Autonomics 15. correct answer: 2 category: Autonomics 16. correct answer: 3 category: Autonomics 17. correct answer: 2 category: Autonomics 18. correct answer: 1 category: Autonomics 19. correct answer: 2 category: Autonomics 20. correct answer: 1 category: Autonomics 21. correct answer: 5 category: Autonomics 22. correct answer: 2 category: Autonomics 23. correct answer: 4 category: Autonomics 24. correct answer: 1 category: Autonomics 25. correct answer: 3 category: Autonomics 26. correct answer: 3 category: Autonomics 27. correct answer: 2 category: Autonomics 28. correct answer: 3 category: Autonomics 29. correct answer: 1 category: Autonomics 30. correct answer: 1 category: Autonomics 31. correct answer: 2 category: Autonomics 32. correct answer: 2 category: Autonomics 33. correct answer: 2 category: Autonomics 34. correct answer: 1 category: Autonomics 35. correct answer: 5 category: Autonomics 36. correct answer: 5 category: Autonomics 37. correct answer: 3 category: Autonomics 38. correct answer: 5 category: Autonomics 39. correct answer: 4 category: Autonomics 40. correct answer: 1 category: Autonomics 41. correct answer: 2 category: Autonomics 42. correct answer: 1 category: Autonomics 43. correct answer: 4 category: Autonomics 44. correct answer: 5 category: Autonomics 45. correct answer: 4 category: Autonomics 46. correct answer: 1 category: Autonomics 47. correct answer: 4 category: Autonomics Autonomics Formative ExamPage 22
  23. 23. Marc Imhotep Cray, M.D. 48. correct answer: 4 category: Autonomics 49. correct answer: 4 category: Autonomics 50. correct answer: 5 category: Autonomics 51. correct answer: 5 category: Autonomics 52. correct answer: 5 category: Autonomics 53. correct answer: 4 category: Autonomics 54. correct answer: 4 category: Autonomics 55. correct answer: 4 category: Autonomics 56. correct answer: 3 category: Autonomics 57. correct answer: 4 category: Autonomics 58. correct answer: 5 category: Autonomics 59. correct answer: 3 category: Autonomics 60. correct answer: 1 category: Autonomics 61. correct answer: 1 category: Autonomics 62. correct answer: 4 category: Autonomics 63. correct answer: 5 category: Autonomics 64. correct answer: 4 category: Autonomics 65. correct answer: 4 category: Autonomics 66. correct answer: 2 category: Autonomics 67. correct answer: 4 category: Autonomics 68. correct answer: 5 category: Autonomics 69. correct answer: 3 category: Autonomics 70. correct answer: 2 category: Autonomics 71. correct answer: 5 category: Autonomics 72. correct answer: 2 category: Autonomics 73. correct answer: 2 category: Autonomics Autonomics Formative ExamPage 23

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